High levels of secondhand smoke exposure in children are known to have adverse consequences for arterial health. However, there is no information about the proportion of children in England that are exposed to these levels, whether it has changed over time and whether it has changed in response to the introduction of smoke-free legislation in 2007.
Evidence suggests that legislation making enclosed public places and work-places smoke-free has reduced secondhand smoke exposure in non-smoking adults. There have however been concerns that smokers may smoke more at home if they cannot smoke in public places. This displacement of smoking to the home could increase exposure among children. In a paper published in Addiction, we report on trends in the proportion of children with high exposure, above a threshold level known to be detrimental to arterial health. Understanding the impact of legislation is important because children who are not so heavily exposed may, by displacement of adult smoking to the home, be exposed to more secondhand smoke and are then pushed over this threshold.
We analysed data from the Health Survey for England conducted between 1996 and 2008. These surveys measured cotinine, an indicator of tobacco smoke exposure, in the saliva collected from 16,000 children aged between 4 and 15.
We found that the proportion of children exposed to damaging levels of second-hand smoke has fallen over time. Amongst children in England, the percentage fell from 24% in 1996 to 13% in 2008. Despite the reduction over time, a large proportion of children continue to be highly exposed to second-hand smoke. In 2008, 49% of children living in homes allowing smoking inside and 34% of those with at least one parent who smokes had levels of exposure known to have adverse consequences for arterial health.
The research also reveals that legislation did not increase the proportion of children exposed to damaging levels of secondhand smoke. This strengthens evidence from England and other countries of the United Kingdom that legislation to prohibit smoking in public places and work-places does not displace adult smoking to the home.
The study was funded by the Department of Health.
The published paper can be accessed here:
Commentary on the paper can be accessed here: